| NPI | 1104644012 |
|---|---|
| Doing Business As | OPAL WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | VALERIE CIVELLI CEO 661-829-5009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2024-11-10 |